Clinical Study of Acid-Base Disturbance of Newborn with Respiratory Failure before and after Mechanical Ventilation

Objective To explore the types and clinical features of acid-base disturbance of newborn with respiratory failure before and after mechanical ventilation. Method The blood gas data before and after mechanical ventilation of 81 cases of newborn with respiratory failure were analyzed. Results 105 out of 120 cases (87.5%) showed acid-base disturbance before mechanical ventilation. The types of acid-base disturbance were respiratory acidosis (38 cases, 36.2%), respiratory acidosis combined metabolic alkalosis (28 cases, 26.7%), respiratory acidosis combined metabolic acidosis (17 cases, 16%), metabolic acidosis (9 cases, 8.57%), respiratory alkalosis combined metabolic acidosis (6 cases, 5.71%), respiratory alkalosis (5 cases, 4.76%) and metabolic alkalosis (2 cases, 1.9%). The simple low oxygenmia was 5.71%(6 cases). 104 out of 180 cases(57.8%) showed acid-base disturbance after mechanical ventilation. The types of acid-base disturbance were respiratory alkalosis(36 cases,34.6%), respiratory alkalosis combined metabolic acidosis (16 cases,15.4%), metabolic alkalosis(14 cases,13.5%), respiratory acidosis combined metabolic alkalosis(12 cases,11.5%), respiratory acidosis(7 cases,6.73%), respiratoryalkalosis combined metabolic alkalosis(6 cases, 5.77%), respiratory alkalosis combined metabolic alkalosis and metabolic acidosis (6 cases,5.77%), metabolic acidosis (5 cases,4.81%), and respiratory acidosis combined metabolic acidosis (2 cases,1.92%). Conclusions Respiratory acidosis and respiratory acidosis combined metabolic alkalosis were the most common type of acid-base disturbance before mechanical ventilation. And all kinds of low ventilation and lack of oxygen may cause metabolic acidosis or double acidosis. Respiratory alkalosis and respiratory alkalosis combined metabolic acidosis were the most common type of acid-base disturbance after mechanical ventilation, and medical tri-disturbance were usually ignored. Respiratory failure combined acid-base disturbance is an important factor in respiratory failure prognosis. Blood gas should be monitored during the treatment with respiratory machine and respiratory index should be adjusted to avoid the over-ventilation and medical acid-base disturbance.